Dr Sumaira Pervez, a radiologist from Pakistan, whose mother had Cytoreductive surgery and HIPEC by Dr Aditi, talks about her experience with HIPEC
When my mom was diagnosed with pseudomyxoma peritonei I was told by the surgeons that the only treatment was cytoreductive surgery with HIPEC but nobody was enthusiastic about doing it. Nobody offered any hope and they chose rather not to do it. One reason was that the HIPEC component was not available in Pakistan and another was that since it is such a rare disease nobody had any experience with cytoreductive surgery. At most the surgeons had done 1 or 2 procedures with not very favourable results.
It is known as the “Mother of all Surgeries”. The procedure is of a radical nature and carries high morbidity and mortality. It is a relatively new procedure but the technique has been refined over the last few years. The greatest fear stems from ignorance. Many surgeons have just heard about the procedure and have no experience with it. A surgeon who is a specialist in peritoneal surface malignancies knows how best to choose patients for this procedure. Done properly and having a low grade tumor increases your life expectancy by upto 15-20 years.
It is a serious surgery and requires careful monitoring and might result in extended stay in the hospital. Life changes after the surgery but it is nothing that can’t be managed. Recovery is slow and prolonged. An advantage that I felt over other tumour therapies was that since the chemotherapy is direct and is a single session the patient does not have to undergo the many side effects of systemic chemotherapy like nausea, vomiting and hair loss.My mom has a pretty reasonable quality of life. She suffers from loss of appetite, abdominal cramps and altered bowel habits but is recovering well and getting back to her routine. She is physically active and is slowly improving.
Given the fatal nature of the disease and a reasonably good outcome of the surgery with the ability to maintain a fairly good quality of life, patients of pseudomyxoma peritonei should undergo the procedure.